What Is Civil Commitment?
Civil commitment is a process in which a judge decides whether a person who is alleged to be mentally ill should be required to go to a psychiatric hospital or accept other mental health treatment. A person in the process of a commitment sometimes is called an Alleged Mentally Ill Person (AMIP). A civil commitment is not a criminal conviction and will not go on a criminal record.
When a civil commitment petition has been filed, an investigator from the community mental health program (CMHP) will investigate the need for the commitment. Depending on the investigator’s decision, the case may be dismissed without a hearing, the person may go into a diversion program or a hearing may be held. If a hearing is held, the person has a lawyer and witnesses testify. The judge then makes a decision whether the person should be committed. If the person is committed, the person may be hospitalized or may be required to undergo treatment in some other setting.
Who Can Be Committed?
A person can be committed if after hearing from witnesses a judge finds by clear and convincing evidence that the person has a mental disorder and, because of that mental disorder, is:
- Dangerous to self or others, or
- Unable to provide for basic personal needs like health and safety.
Or, the judge can find that a person is:
- Diagnosed as having a major mental illness such as schizophrenia or manic-depression, and
- Has been committed and hospitalized twice in the last three years, is showing symptoms or behavior similar to those that preceded and led to a prior hospitalization and, unless treated, will continue, to a reasonable medical probability, to deteriorate to become a danger to self or others or unable to provide for basic needs.
How The Civil Commitment Process Begins
- The commitment process may be started by a county health officer, a judge, or any two persons filing papers in court. Or, the process may be started by a doctor or community mental health program director ordering a person to be held involuntarily in a hospital.
- When the papers are filed, the CMHP program must send out a mental health investigator to interview the person and others who know about the person. This investigator advises a judge whether or not to hold a court hearing.
Where The Person Stays Before The Hearing
A person against whom a civil commitment petition is filed may stay in the community unless the judge orders the person to be taken into custody or a doctor or CMHP director directs the person be in custody. The person can be held in custody only if he or she is considered to be mentally ill and a danger to self or others. A person who is mentally ill and unable to provide for basic needs cannot be held in custody unless the person’s inability to provide for basic needs is so extreme that the person is a danger to self. A person held before a hearing is on a precommitment hold or in precommitment detention.
If a person is held in custody on a precommitment hold, he or she cannot be held in jail unless he or she is charged with a crime or is a serious danger to hospital staff or property. The person may be held in a hospital or a non-hospital facility. A nonhospital facility is a facility approved by the Mental Health and Developmental Disability Services Division (MHDDSD) to provide adequate security, psychiatric, nursing and other services.
A person on a precommitment hold has the right to be held in a mental health facility providing care, custody and treatment required for mental and physical health and safety. In other words, the person can only be held in a place with staff trained to provide mental health treatment.
Length of Time A Person Can Be Held Before A Hearing
A person cannot be held in custody on a precommitment hold longer than five working days without a court hearing. If five working days pass and there is no court hearing, a person is free to leave the hospital unless he or she has asked to postpone the hearing or has agreed to be hospitalized voluntarily under a diversion program. In other words, a person cannot be held longer than five working days unless a judge says so.
Rights Of A Person In Custody On A Precommitment Hold
- A person shall not undergo electroshock therapy or unduly hazardous treatment.
- A person shall receive treatment that is up to community standards.
- A person can be given medication only if the person agrees (informed consent) or if necessary to protect life or safety.
- The treating doctor must approve any use of restraints.
- A person must be given an oral and written warning that whatever he or she does or says in the hospital may be used as evidence in court commitment hearings. The civil commitment court does not recognize doctor/patient confidentiality for a person being held for a civil commitment hearing. In other words, anything a person says to staff or the doctors can be told to the judge at the hearing.
- The person has a right to have a lawyer. A lawyer will be appointed or a person can contact his or her own lawyer.
- A person and his or her lawyer have the right to ask for a postponement of the hearing. If the judge finds good cause, the judge may postpone the hearing for no more than five working days. The judge may order the person to remain in custody. The lawyer representing the state and the person’s guardian also may ask for a postponement for five working days. In this case, if the judge finds good cause, the judge can postpone the hearing but cannot hold the person in custody any longer.
- If the director, the lawyer and individual agree, a person may be certified for a 14 day diversion program. In this case, the hearing is postponed and may never occur.
What Happens When A Civil Commitment Petition Has Been Filed?
After the petition has been filed, several different things may happen. The petition may be dismissed without a hearing. If the person is being held on a precommitment hold and the petition is dismissed, the person must be released. The person may be found eligible for a 14 day diversion program. The person may have a civil commitment hearing.
14 Day Diversion Program
A person on a precommitment hold may be certified for a 14 day period of intensive treatment. This 14 day period commonly is called “diversion”. The word “diversion” is not used in the statute, but it is used in the Oregon Administrative Rules.
If the Community Mental Health Professional (CMHP) director believes a person is mentally ill and if there is a placement that can give the person necessary and sufficient treatment, the director can certify the person for the 14 day treatment period. The certification includes a statement of the treatment the person will receive. The director must make this certification no later than three days after the person was put on the hold. As soon as the court receives this certification, the court must appoint a lawyer or notify the person’s lawyer if he or she already has one.
The attorney must review the certification with the person within 24 hours of when the certificate was delivered to the court. A person can be held for the 14 day treatment program only if the person and the attorney agree.
If a person agrees to the 14 day program then changes his or her mind, the person can ask for a hearing. A hearing will be held within five working days. If a person refuses treatment, the community mental health director can ask for a hearing and it will be held within five working days.
During the 14 days, a person may be transferred from a hospital to a nonhospital facility or transferred from a non-hospital facility to a hospital.
A person may be discharged at any time during the 14 days. A person may agree to voluntary treatment and have the case dismissed. If a person is still being held involuntarily after 14 days, a hearing must be held.
The Civil Commitment Hearing
If a hearing is held, it can take place in the courthouse (usually in Room 220) or the place where the person is being held.
If the hearing is at the courthouse, the person will be taken to the courthouse for the hearing.
Usually a police or sheriff’s officer drives the person to court.
A judge will preside over the hearing. The person who is alleged to be mentally ill, his or her attorney, a Multnomah County Deputy District Attorney (representing the state) and the mental health examiners will also be present. Mental health examiners are doctors or other persons certified by the state to make examinations at commitment proceedings. The judge will appoint a mental health examiner for the hearing. If requested, the judge will appoint a second examiner also.
Additionally, the investigator and witnesses may be at the hearing. A civil commitment is an open proceeding, so family, friends and others can attend the hearing. Witnesses may be asked to wait outside the courtroom while others are testifying so they will not be affected by what others have said.
What Happens At The Hearings
- Witnesses testify. The attorney for the allegedly mentally ill person, the attorney for the state, the mental health examiner and the judge may ask them questions. The attorney for the state will call witnesses to testify about why the person is mentally ill, dangerous to self or others or unable to provide for basic needs. A person alleged to be mentally ill also has the right to call witnesses to testify.
- The mental health examiners usually ask questions of the person alleged to be mentally ill and they will give the judge written opinions about the person’s mental condition.
- The person alleged to be mentally ill or the attorney may cross-examine the witnesses, the mental health examiners and the investigators.
- The person alleged to be mentally ill can testify and can have witnesses testify for him or her. The attorney for the state can cross-examine any of these witnesses.
- The attorneys should make statements to the judge about why the person should or should not be committed.
- After hearing all the evidence and reading the conclusions of the mental health examiners, the judge must make a decision whether the person should be committed.
What The Judge Can Do
The judge decides whether the person is mentally ill. In civil commitment, mentally ill means having a mental disorder and being dangerous to self or others or unable to care for basic needs or meeting the expanded criteria regarding prior hospitalization.
If the judge finds the person is not mentally ill, the judge must release the person and dismiss the case.
If the judge finds by clear and convincing evidence that the person is mentally ill (having a mental disorder and dangerous to self or others or unable to care for basic needs), the judge can do one of the following:
- Release the person if the judge finds the person is willing and able to participate in treatment on a voluntary basis and the judge finds the person probably will do so.
- Conditionally release the person to the custody of a friend or relative.
- Order the person committed to the Mental Health and Developmental Disability Services Division (MHDDSD) for treatment for no more than 180 days. MHDDSD may place the person in a hospital or other facility. MHDDSD also may place the person on “outpatient commitment”, meaning the person will be treated outside of a hospital setting.
What Happens To The Person After The Hearing
If the court discharges a person, the person is free to leave and do whatever he or she wants to do.
If the person is conditionally released, the person is released to the custody of a friend or relative with certain conditions the judge says the person has to follow. These conditions may include seeing a mental health worker or taking medication. The friend or relative is supposed to tell the court if the person does not follow these conditions. The conditions stay in effect for the period the judge says, but no longer than 180 days.
If a person is committed on an outpatient basis, the person will be released under the supervision of the CMHP. The CMHP will place conditions on the release. If the person does not follow these conditions, the CMHP may tell the court. The conditions stay in effect for the period the judge says, but no longer than 180 days.
What Happens If A Person Does Not Follow The Conditions of The Release Or Outpatient Commitment
If a person is released on conditional release or on outpatient commitment and the judge is told that the person has broken a condition, the judge may have a hearing to see if the person has broken the conditions. The person has the right to an attorney and the other rights granted a person at the civil commitment hearing. The person can be held in custody before the hearing. If the person is held in custody, the hearing must be within five working days of when the person went into custody.
If the judge finds that the person has broken a condition, the judge can:
- Continue the placement with the same or different conditions, or
- Order the person returned to the custody of Mental Health Developmental Disabilities Services Division (MHDDSD) for involuntary care and treatment.
Length Of A Commitment
A commitment can last no longer than 180 days. A person can be released from the hospital at any time before 180 days passes if the treating doctor or director of the facility believes the person no longer is mentally ill. The hospital cannot keep a person for longer than 180 days unless the person agrees to stay or is recommitted in another process.
If a person is committed and goes to a hospital or other facility, MHDDSD can agree with the CMHP director to release a person on a trial visit. On a trial visit, a person is released to the community with certain conditions. Often the conditions include requirements that the person take certain medications or attend specific therapy sessions.
If a person on a trial visit breaks the conditions of the trial visit, he or she cannot be sent back to the hospital or other facility unless the judge orders this after a hearing. The person has the same rights as the person who is charged with violating the conditions of an outpatient commitment or conditional release.
If a person stays in the hospital or facility for the 180 days and the state still thinks the person needs to be there, the state can try to recommit the person. Before the 180 day commitment runs out, the hospital will give the person papers asking if he or she agrees to stay. If the person wants to leave the hospital, he or she must protest recommitment by signing a protest form or telling the hospital staff. The person has 14 days from when he or she gets the papers to do this. If the person does not protest, he or she may be recommitted automatically for up to 180 days.
If the person protests recommitment, the hospital may not keep him or her unless there is a hearing and the judge decides if he or she needs to stay. For purposes of the court hearing, the person has a right to:
- Be represented by a lawyer or have a lawyer appointed if the person cannot afford one.
- Have a doctor or other qualified person who is not on the staff of the hospital examine the person’s mental condition and report the results to the judge.
Appeals Of Civil Commitments
A person has the right to appeal the judge’s decision. An appeal is a legal way to challenge the judge’s decision. Appeals usually take longer than 180 days to complete. If the commitment is reversed, the person probably will not get out of the hospital sooner but other rights may be preserved.
A person should contact his or her commitment hearing lawyer about appealing. Appeal papers must be filed within 30 days of the judge’s decision. If a person cannot afford to hire a lawyer to handle the appeal, one will be appointed.
How Legal Rights Are Affected By Commitment
In general, most legal rights are not affected by civil commitment. A person who is committed retains all legal and civil rights, including the right to vote and make contracts unless a court has found the person incompetent.
Some specific rights can be limited as a result of civil commitment:
Firearms – Persons who have been committed are forbidden from owning, buying, or possessing firearms.
Future commitments – If a person is committed twice within the past three years, he or she can be committed more easily in the future.
Driving – Commitment can affect a person’s ability to get or keep a driver’s license. If a person has a mental disability or disease that prevents the person from exercising reasonable and ordinary control over a motor vehicle, the person cannot be licensed.
Other Information About Civil Commitments
Who pays for it? The cost of hospitalization commitment may be billed to the individual. This bill will go to the person’s insurer if he or she has insurance. If a person does not have insurance or enough money to pay, the government will pay the bill.
Can a person sue if someone falsely accuses him or her of being mentally ill? Anyone can sue but a person cannot win a suit against someone for accusing him or her of being mentally ill or for taking part in the commitment if that person acted in good faith, on probable cause and without malice.
Can a guardian, friend or relative be sued for things the person did while released to the custody of the guardian, friend or relative? As long as the guardian, friend or relative acts in good faith and without malice, he or she cannot be held liable for another person’s actions.
Copies of the commitment record. A person can request a transcript of what the witnesses said in court, but there is a fee for this.
Confidentiality. All treatment records are confidential. The fact that a person was committed is not confidential but is usually only revealed in special circumstances such as when police check to see if a person is prohibited from purchasing a firearm.